Health Insurance

Rescinded 1981

Where, under the provisions of P.L. 89-732 the Attorney General, upon
application by a Cuban refugee, adjusts the status of such alien to that
of alien lawfully admitted for permanent residence and records a date of
such admission retroactively, held for purposes of determining when
such alien met the lawful admission requirement under section 103(a)(4) of
P.L. 89-97 for establishing entitlement to hospital insurance benefits
under Part A of title XVIII of the Social Security Act, the retroactive
date of admission recorded by the Attorney General governs; in determining
when such alien met the lawful admission requirement under section
1836(2)(A) of the Social Security Act for establishing eligibility for
enrollment for supplementary medical insurance benefits under Part B of
title XVIII of the Social Security Act, the date the Attorney General
adjusted such alien's status governs

Public Law 89-732 (80 Stat. 1161), enacted November 2, 1966, added a
provision to the Immigration and Nationality Act whereby the Attorney
General may adjust the status of certain Cuban refugees to that of aliens
lawfully admitted for permanent residence in the United States. Under the
provisions of P.L. 89-732, as pertinent here, an alien's status may be so
adjusted if he is a native or citizen of Cuba, has been physically present
in the United States for at least 2 years, and makes application for this
adjustment. If such alien was admitted as a refugee into the United States
after January 1, 1959, and applies for adjustment of his status, the
record of his admission for permanent residence will show a date 30 months
prior to the date of the application or the date of his last arrival into
the United States for permanent residence before November 1, 1966, and
makes application to have his date of lawful admission adjusted, the
Attorney General shall record admission for permanent residence as of the
date the alien originally arrived in the United States or May 1964,
whichever is later.

Section 103(a) of Public Law 89-97 (the Social Security Amendments of 1965
(79 Stat. 286)) provides, as pertinent here, that a person age 65 or over
who cannot meet the requirements of section 226 of the Act for entitlement
to hospital insurance benefits under Part A of title XVIII because he is
neither entitled to monthly benefits under section 202 of the Act nor a
qualified railroad retirement beneficiary, may nevertheless become
entitled to hospital insurance benefits, if, (among other requirements) he
files an application and;

(4) is a resident of the United States (as defined in section 210(i) of
the Social Security Act), and is (A) a citizen of the United States or (B)
an alien lawfully admitted for permanent residence who has resided in the
United States (as so defined) continuously during the 5 years immediately
preceding the month in which he files application under this section,
***.

An application for hospital insurance benefits under section 103(a) may be
effective retroactively for as many as 12 months before the month in which
such application is filed. There is no provision for retroactively of an
application for supplementary medical insurance benefits.

Section 1836 of the Act provides that a person age 65 or over may enroll
in the supplementary medical insurance program under Part B of title XVIII
if he:

(2)(A) is a resident of the United States, and is either (i) a citizen or
(ii) an alien lawfully admitted for permanent residence who has resided in
the United States continuously during the 5 years immediately preceding
the month in which he applies for enrollment * * *, or (B) is entitled to
hospital insurance benefits * * *.

The question to be resolved is whether the retroactive date of lawful
admission under P.L. 89-732 may be used for purposes of determining an
uninsured alien's date of entitlement to hospital insurance benefits and
for determining his enrollment period for supplementary medical insurance
benefits.

The phrase "lawfully admitted for permanent residence," as found in
section 103(a)(4) of P.L. 89-97 and section 1836(2)(A) of title XVIII, is
a term of art adopted from the Immigration and Nationality Act, in section
101(a)(20) of which it is defined (8 U.S.C. 1101(a)(20)). Accordingly, the
phrase has the same meaning in title XVIII as it does in the Immigration
and Nationality Act. The Administration, in its determinations of the
Attorney General and his delegates as to the fact of lawful admission,
since only that official is authorized by statute to make such
determinations.

Accordingly, there is no question as to the retroactive lawful admission
status of the Cuban refugees for purposes of hospital insurance coverage
under part A of title XVIII. The retroactive admission date, as determined
by the Attorney General under P.L. 89-732, is controlling as to when the
alien met the statutory requirement of lawful admission, so that if the
alien meets all of the other requirements of coverage (including the
filing of an application) he may be entitled to retroactive part A
coverage for up to 12 months.

With respect to part B coverage, however, the question is more complex. If
we were to treat the Attorney General's retroactive admission date as
controlling for purposes of establishing the date of eligibility to enroll
under part B, the effect would be to delay rather than expedite the
possibility of part B coverage for Cuban refugees who were the
beneficiaries of P.L. 89-732.

Under part B, an individual has a limited period in which to enroll. If he
fails to enroll in his initial enrollment period (a 7-month period that is
based upon the date he first becomes eligible to enroll) he may have to
wait until the following year to enroll and his coverage will be delayed
accordingly. In addition, he may be required to pay an additional premium
because of his late enrollment.

Thus, a rigid application of the retroactive provisions of P.L. 89-732 is
part B of title XVIII would have the effect of denying the beneficiaries
of that statute the opportunity to obtain prompt part B coverage by
imputing to them a fictitious failure to enroll in the initial enrollment
period as determined retroactively. Such an interpretation would be
contrary to the purposes of P.L. 89-732 and part B of title XVIII of the
Social Security Act, both of which were intended to offer opportunities
for coverage rather than obstacles to the parties affected by the
legislation.

Accordingly, it is held that where the Attorney General, under P.L.
89-732, adjusts the status of a Cuban refugee to that of an alien lawfully
admitted for permanent residence and records a retroactive date of lawful
admission, such retroactive date is controlling in determining when the
alien met the lawful-admission requirement of section 103(a)(4) of P.L.
89-97 for purposes of entitlement to hospital insurance benefits. It is
further held that in determining when such alien met the
lawful-admission requirement of section 1836(2)(A) of the Act for purposes
of establishing his enrollment period for supplementary medial insurance
benefits, the determinative date for lawful admission is not the
retroactive recorded date of admission but the date on which the Attorney
General actually adjusts the alien's status.

Important Information:

Other Government Websites:

Follow:

External Link Disclaimer

You are exiting the Social Security Administration's website.

Select OK to proceed.

Disclaimer

The Social Security Administration (SSA) website contains links to websites not affiliated with the United States government. These may include State and Local governmental agencies, international agencies, and private entities.

SSA cannot attest to the accuracy of information provided by such websites. If we provide a link to such a website, this does not constitute an endorsement by SSA or any of its employees of the information or products presented on the non-SSA website.

Also, such websites are not within our control and may not follow the same privacy, security or accessibility policies. Once you visit such a website, you are subject to the policies of that site.